Appendiceal (Appendix) Cancer Causes and Risk Factors

Appendiceal cancer is a relatively uncommon tumor that forms in the appendix, a small pouch-like organ attached to the large intestine in the lower right abdomen. Although its function is not entirely clear, scientists believe the appendix may play a role in gut immunity, mainly because it contains a high concentration of immune cells and serves as a storehouse for beneficial bacteria. After a severe gastrointestinal (GI) infection, such as a prolonged bout of diarrhea, the appendix may help repopulate the intestines with healthy gut bacteria.

Usually, appendiceal cancer does not produce noticeable symptoms until it progresses or causes complications, such as appendicitis. In some cases, the tumor is found during a medical examination, imaging test or surgical procedure performed for an unrelated reason. Treatment may include surgical removal of the appendix (appendectomy) and possibly chemotherapy or radiation therapy.

What causes appendiceal cancer?

Appendiceal cancer develops when cells in the appendix undergo harmful DNA changes that cause the cells to grow uncontrollably and live beyond their normal lifespan. Over time, the excess cells can build up, bind together and form a tumor. Through ongoing research studies, scientists continue to investigate possible triggers of the cellular mutations that lead to the development of appendiceal cancer.

What are the risk factors for appendiceal cancer?

Risk factors are characteristics, behaviors and exposures that can increase the likelihood of developing appendix cancer, although they do not directly cause it. While some appendiceal cancer risk factors can be controlled, others cannot.

Appendiceal cancer risk factors that can be controlled

By making healthy lifestyle changes, it may be possible to control certain appendix cancer risk factors, such as:

• Tobacco use – Smoking is a significant risk factor for many types of cancer, including appendiceal cancer, and quitting is a key preventive strategy.
• Long-term antacid use – Although the results are inconclusive, some studies suggest that chronic use of certain antacids for heartburn and acid reflux relief may increase the risk of appendix cancer.

Appendiceal cancer risk factors that cannot be controlled

Certain appendix cancer risk factors cannot be controlled, such as:

• Advanced age – Although appendiceal cancer can occur at any age, most cases are diagnosed after age 50.
• Certain inherited cancer predisposition syndromes – Familial adenomatous polyposis (FAP), Lynch syndrome and multiple endocrine neoplasia type 1 (MEN1) syndrome have been linked to appendix cancer.
• Other cancers – The risk of appendiceal cancer increases with a personal history of GI tumors or a family history of appendiceal cancer.
• Low stomach acid (hypochlorhydria) – Certain medications, such as H2 receptor blockers and proton pump inhibitors (PPIs), and certain medical conditions, such as pernicious anemia, atrophic gastritis, Zollinger-Ellison syndrome and Helicobacter pylori (H. pylori) infection, can interfere with the function of the acid-secreting glands in the stomach. Hypochlorhydria may be associated with GI cancer, including appendiceal cancer.

Can appendiceal cancer be prevented?

Preventing appendix cancer is challenging, primarily because the specific causes and risk factors are not fully understood. However, certain steps can be taken to help reduce the risk of cancer in general. These include:

• Making healthy lifestyle choices – Eating a nutritious diet, exercising regularly, avoiding tobacco use and limiting alcohol consumption can contribute to overall good health and potentially lower the risk of developing various cancers, including appendiceal cancer.
• Having routine physical examinations – Early detection is key to the successful management of any type of cancer, including appendix cancer. Regular medical checkups can help identify precancerous and cancerous changes early so they can be promptly addressed.
• Seeking genetic testing and counseling – Individuals who have a genetic risk factor for appendiceal cancer may benefit from an in-depth assessment of their risk profile, which can help them make better-informed healthcare decisions.

Frequently asked questions (FAQs) about appendiceal cancer causes and risk factors

The following FAQs-related article provides additional information about appendiceal cancer causes and risk factors:

• Is appendix cancer hereditary?

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s Gastrointestinal Oncology Program has received national recognition for its landmark discoveries and robust portfolio of clinical trials, which are helping us expand our knowledge base and learn more about appendix cancer causes and risk factors every day. We take a bench-to-bedside approach to cancer care, quickly translating our research breakthroughs into screening, diagnostic and treatment strategies for our patients. For these reasons and many others, Moffitt has been designated a Comprehensive Cancer Center by the National Cancer Institute, and we have earned the respect of our patients and peers across the nation.

If you would like to learn more about appendiceal cancer causes and risk factors, you can request an appointment with a specialist in our Gastrointestinal Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.